Lack of Customer Service in the USA

[N80]

Yes, that's a whole other can of worms.

First, the AMA is an advocacy group for patients and doctors. It has no say so in any legislative matters. And as a group it is a relatively powerless organization. The FDA controls the use of prescription drugs in this country. It is a government organization and physicians in general have no involvement. The AMA does lobby politicians, but it is a two-bit operation compared to drug companies and insurers.

Patient access to antibiotics is a huge mistake. Bronchitis is rarely bacterial and even with known bacterial infections like sinusitis and ear infections the data are showing that not only are antibiotics of limited use but quite harmful. Overuse of antibiotics is an enourmous health issue in this country mostly because we doctors over use them. Of course the typical American patient is to blame as well. People request them from me and get angry when I tell them they have a virus and don't need them. If the American public had access to antibiotics our problems of bacterial resistance would be even worse. The problem is already huge and there are few new antibiotics emerging to fill the gaps left by resistant bacteria like MRSA. And if things continue as is, we are going to set ourselves back to the pre-penicillin days when untold thousands die from simple staph infections. Access to antibiotics is a BAAAAAAAAAAAAAD idea.

But don't get me wrong. It doesn't hurt physician's business. Most physicians don't like the idea because it hurts patients. But the complications of excessive antibiotic use would be great for business. So its not a threat to our paychecks that concern us.

 

[CDsdad]

...... The AMA does lobby politicians, but it is a two-bit operation compared to drug companies and insurers.

Right there, where you typed drug companies and especially insurers, you could have typed thieves and given a better description.

It took me 2 weeks of taking an ineffective drug, another week of calling, and finally 3 hours on the phone to get my insurance company to pay for a prescription because it was considered step therapy. The only reason I got it was because the woman I spoke with first on the last call accidentally told me it was really because they were looking for a cheaper alternative. I threatened to have the recorded call subpoeaned, was transferred to a supervisor, and within 20 minutes my Dr magically had an authorization number.

I filed a complaint, my second useless one, and even tried to contact my companies HR department. HR called back 3 days later. It didn't matter. The lazy hiefer was too dumb to know what I was talking about. She probably reported me to my bosses bosses bossess bosses boss.

I told the insurance supervisor on the phone that if it had been my wife or my children, I would have happily paid out-of-pocket for the medication. Then I told him I would have come found him personally and taken out my anger on him wherever he was. He gave me the typical "We're just employees. We don't make policy" crap.

Bunch of thieves. They don't hesitate to get the money out of my paycheck every two weeks, but they balk quick at paying out. Bunch of thieves.

It's bad enough they tell you that you have to use a Dr in their network, regardless of competency. Then, when you use their guy, they don't want to pay for the medicine he prescribes.

I agree about the rubal analogy, also. Give me my rubals and I'll take care of myself. Same with Social Security that I'll never see. Give me what I've paid so far, keep the interest and they'll never have to worry about me.

 

[Sigarms]

I dont know what happened to the company I do however know what has happened to a lot of companies that were not union. They went bankrupt or they decided to maximize profits by moving overseas. I do however know what happens to a lot of union members since I defend them in arbitration hearings. There is the young man who was discriminated against and won an eeo action. The next week the discipline started within two weeks he was fired. That was not good enough while he was fired and waiting for his arbitration hearing they thought up some new charges totally false and fired him a second time. He got put back to work with full back pay. We never even went to arbitration with his case. When it got to the level of my opposite number in the company they settled it because it was so obvious the firing was retaliation. Maybe I should talk about the young girl who had a baby that was born with a missing enzyme, the baby took six weeks to die after the funeral the girl tried to come back to work off of sick leave. Management started playing games with her paperwork to come back it took her 8 weeks to get back to work. She had to go through the tragedy of having a baby and watching it die then deal with management that wanted to cause her problems. What did it cost the two people in the example above to get back to work and paid. They paid their union dues. I will be the first to admit unions have their problems but try to stand up to abusive management by yourself and see how far that gets you.

I have no doubt that unions were created due to the abuses of labor by management.

That said, from what I've seen in my limited personal experience, it's the union now doing the abusing.

I remember when I got my butt chewed out for sweeping a floor because it wasn't my job.

I remember when I got but butt chewed out for doing somthing other than "my assigned task" because I could finish my task in 4 hours, when it took others 8 hours to do the same job and I became bored.

I remember when union people called in sick and the supervisor had to go down a list and call people to see if they wanted to come in and how that supervisor had to document EVERY single phone call so if someone complains, that supervisors butt is covered.

I remember when people in the union got upset at me for "socializing with management by talking to some guys who happen to have the same interests as myself who were not in the union.

I remember guys complaining that they were only making $17 an hour (close to 20 years ago) and all they did was pull items down from a shelf, eight hours a day. You could train a chimp to do their work, and they were paid good money for non skilled labor, yet these people complained they were not making enough compared to some other union work.

That said, you don't like your job, leave and find another one.

With good management, a union is not nessesary.

 

[Skyco]

BTW Sigarms- don't know where you got your user name but the company of your namesake has lately managed to earn a horrible customer service reputation. I happen to own two of their products and consider them the best but dang they sure can screw stuff up. Go frequent some of the Sig boards if you aren't aware- I suspect you are though if your user name is a clue. Case in point- awhile back they had a couple of promos that they totally hosed up- a free pocket knife was promised if you bought one of their $800 products like I did. When the knife finally arrived it wasn't the nice one pictured but a cheap piece of dung made in China I wouldn't have paid $2 for, much less the $5 shipping they charged!
They also had a promo where one got "free" gear- I bit on that one too and was sent the wrong size garment, their mistake. Guess who had to pay to ship back their mistake?- yep me.
I like the products they make very much, which is what they should stick to since they have screwed up everything else they try IMO. BTW in addition to my ownership of 2 of their products I have bought two other similar products made by another German company in the same business- around $1100 total and it was partly because of Sigarms screw ups- I neither expected nor received any promo items but the products are great

Health insurance- what really gripes me is my HMO negotiates some super discount for everything- a doctor visit costs me $20 and they pay the doctor something like another $20. My son, with no insurance, has to pay $70 because he has no insurance and can't get the "good" rate the HMO gets. It just isn't right, the people who can't afford insurance then get reamed the most because they don't have insurance.

 

[DocHeb]

Health insurance- what really gripes me is my HMO negotiates some super discount for everything- a doctor visit costs me $20 and they pay the doctor something like another $20. My son, with no insurance, has to pay $70 because he has no insurance and can't get the "good" rate the HMO gets. It just isn't right, the people who can't afford insurance then get reamed the most because they don't have insurance.

Offer the doctor the HMO rate, in cash, right at the time of visit. 4:1 odds he will take it.

 

[Skyco]

I doubt it- his practice is now owned by one of the large hospital systems and it is all computerized. The $40 vs $70 example is small change, I've seen procedures where a multi thousand dollar bill is paid off at a couple of hundred by the HMOs agreement, guess what the uninsured pay? Yep the whole thing.

Funny story- some years back I had some jaw surgery and stayed in the hospital a couple of days- it was around $10,000. I asked for and got a complete itemized bill which included a $5 Chapstick I asked for, but I did challenge them on the vaginal packing that was on the bill, told them I was pretty darn sure I did NOT get that no matter how drugged I was In case someone can't tell, I'm a guy.

 

[gemini5362]

Yes, that's a whole other can of worms.

First, the AMA is an advocacy group for patients and doctors. It has no say so in any legislative matters. And as a group it is a relatively powerless organization. The FDA controls the use of prescription drugs in this country. It is a government organization and physicians in general have no involvement. The AMA does lobby politicians, but it is a two-bit operation compared to drug companies and insurers.

Patient access to antibiotics is a huge mistake. Bronchitis is rarely bacterial and even with known bacterial infections like sinusitis and ear infections the data are showing that not only are antibiotics of limited use but quite harmful. Overuse of antibiotics is an enourmous health issue in this country mostly because we doctors over use them. Of course the typical American patient is to blame as well. People request them from me and get angry when I tell them they have a virus and don't need them. If the American public had access to antibiotics our problems of bacterial resistance would be even worse. The problem is already huge and there are few new antibiotics emerging to fill the gaps left by resistant bacteria like MRSA. And if things continue as is, we are going to set ourselves back to the pre-penicillin days when untold thousands die from simple staph infections. Access to antibiotics is a BAAAAAAAAAAAAAD idea.

But don't get me wrong. It doesn't hurt physician's business. Most physicians don't like the idea because it hurts patients. But the complications of excessive antibiotic use would be great for business. So its not a threat to our paychecks that concern us.

I noticed you used the term relativively powerless in your description of the AMA. Do they know that because when I look at this group of web pages I get the impression that they feel they can do a lot to influence legislation.

Also the AMA is an advocacy group for patients and doctors? This is the membeship requirements from the website for the AMA. I dont think as a patient I can join so evidently it is an advocacy group for patients but the only thing advocated is the views of physicians is that correct ?

Membership in the AMA is open to:

Medical students enrolled in a Liaison Committee on Medical Education (LCME) or American Osteopathic Association (AOA) accredited program.

If you are a first-year medical student, please enroll through your AMA-MSS chapter membership liaison. If you do not know who your liaison is, contact Kristen Tinney or by phone (800) 262-3211, ext. 4935, for assistance.

Resident physicians who are attending an accredited residency or fellowship program in the United States, Puerto Rico, Guam or the Virgin Islands.

Physicians who have earned their doctor of medicine or doctor of osteopathy degree and are residing and practicing in the United States, Puerto Rico, Guam or the Virgin Islands.

All members must abide by the Principles of Medical Ethics.

The above statements are taken from the AMA website. It would seem to me that the AMA is pretty much open just to physicians or people on their way to becoming one ?


I dont know whether I get bronchitis or not I guess all I know is that my doctor tells me I have bronchitis, she always gives me anti biotics and it gets better. Same as when I get pneumonia. If you say anti biotics dont help with my problem when I get these diseases then I am very disapointed because my doctor does not seem to know what she is talking about and I dont know what I am going to do the next time I come down ill.


All I can say is my experience with living in a country where a lot of medications are available at a pharmacy without a prescription. Some of the diseases that I have had more than once I went to the drugstore and boughtthe appropriate medicine for them and seemed to have gotten better. Having drugs available to the general public might be the problem you say it is but to be honest it is done in other countries without the problems you indicate. It would also give people without insurance a chance to get medication at about 30 to 40 per cent of the cost they have to pay now.

 

[gemini5362]

I have no doubt that unions were created due to the abuses of labor by management.

That said, from what I've seen in my limited personal experience, it's the union now doing the abusing.

I remember when I got my butt chewed out for sweeping a floor because it wasn't my job.

I remember when I got but butt chewed out for doing somthing other than "my assigned task" because I could finish my task in 4 hours, when it took others 8 hours to do the same job and I became bored.

I remember when union people called in sick and the supervisor had to go down a list and call people to see if they wanted to come in and how that supervisor had to document EVERY single phone call so if someone complains, that supervisors butt is covered.

I remember when people in the union got upset at me for "socializing with management by talking to some guys who happen to have the same interests as myself who were not in the union.

I remember guys complaining that they were only making $17 an hour (close to 20 years ago) and all they did was pull items down from a shelf, eight hours a day. You could train a chimp to do their work, and they were paid good money for non skilled labor, yet these people complained they were not making enough compared to some other union work.

That said, you don't like your job, leave and find another one.

With good management, a union is not nessesary.

Actually we are in complete agreement, at least, on this post. With good management you dont need a union. I have worked for companies that had good management and really did not need a union. Unfortunatly there are a lot of companies that have management problems. I agree that your experiences with the union were not fair to you. Or they might not have even been a good call on the unions part. I have refused to file grievances even though management broke the contract. If they have a good reason for doing it and it is a solution to a problem that is of a limited nature. I go to the union member and tell them why I dont want to file a grievance and usually they agree. The experience about calling someone in. On this subject I would give you my opinion of that one. In our contract overtime is by seniority in a rotational basis. The first overtime in a quarter is to the senior person on the OT list the next is to the second senior etc etc. I believe that section of the contract is to keep a mangager from calling up his buddy everytime they need overtime and having the rest of the people not get a chance for the extra pay.

 

[toy]

When we talk about unions there is something left outbecause it is understood by every one the meaning but sometimes we need to be more specific as an example UnitedAuto Workers of America or United Steel Workers of America and so on a good union member is a good worker as the name implies. I know some union members don't meet that qualification so people beat up on unions because of these people, but it is the place of the company to deal with these kinds of workers and there is procedural steps to do so. I have seen some union members that should go company because they are not a union person [they would sell their mother out to get a point with the employer], the unions should have more power to dicipline its members to keep them in line doing what they are supposed to do to make the company as prosperious as possible and not causing a union brothers work load to be any harder than necessary [example one union member straining to do a job and another sitting there claiming that is not his job]. All of that being said when a union gets any kind of benefit increase for its members then the bosses get a better slice of the pie to and every body does better. It is under those conditions that America's standard of living raised not because the companies really loved its employees and wanted them to have the benefits that we enjoy today, benefits that are slowly sliping away. I haven't saw any one mention I don't beleive a ceo on the other hand taking a company running it into near bankruptcy taking a severance package of more than what several of their hourly employees can make in a lifetime. I think that is more of the problem than some poor working slob being able to take his sick child to a doctor and getting his child cared for on his company paid insurance card. I think there ought to be a better way of getting healthcare to Americans than letting insurance companies have control of our healthcare. The way the insurance companies did the people affected by hurican Katrina that had insurance with their companies lets me know just how trustworthy they are. A friend of mine about two years ago needed a lung transplant the doctors said that he needed it urgently. Notified his insurance company of his needs, they denied, drug their feet everything they could do to put off approving his surgery long story short he got his approval the day he died there was no need for surgery then. Now after saying all that I think we need to look at the corporate greed that has its grip on America and the leaders that have sold out to them. The econimists say that American consumer wants the cheapest product but they don't consider if the consumer looses his job and has no income then he is no longer a consumer. I talked to a man a while back and I know he had worked for over 30 years in an industry , he said that he was going to have to retire because of health reasons. I said to him at least he would have a good retirement and he said no the company he worked for was nonunion and didn't have a retirement package and the company went bankrupt, I feel for him. I don't want to blame some poor person for the problems we are having I want to consider who's getting all the money; his deepfreezer is already full of t-bone steaks and his mouth is watering wanting your hamburger are you going to give it to him or are you going to say no? I was listening to a man that ran a small business and he seemed pleased that some people in the community had lost their income level and it seemed to please him never gave it a thought that those people were his customers. Sorry for being soo long.

 

[LMTC]

Ummm, fee, fi, fo, fum, I hear the drum of socialism. I wondered how long before this thread deteriorated into rah-rah unionism and bashing people who make money. I remember during the independent (so-called) trucker's strike somewhere around '86 having to haul some hay somewhere, and a local independent trucker telling me to my face that if he saw me hauling anything he would shoot me....and I believe he was serious. He was bitterly angry, and said anyone hauling during the strike was messing with his "right" to earn a living. I asked him about MY right to earn a living, and that didn't matter...he thoroughly and completely believed I should bow to collectivism.

All these alleged horror stories about mean old insurance companies are simply further reasons why we should take control of our own destiny and quit demanding that someone else provide for us. Unfortunately, for some people it seems to be a reason for more regulations.